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Purpose: This paper describes the process of developing an instrument to test the middle-range nursing theory for the self-care of home-dwelling elderly. Background: Instrument development is a multiphase process, during which the researcher tests the reliability and validity of the instrument with various data and modifies it based on the test results. The aim of the study was to develop an instrument to test a theory, but also to be able to use it later in clinical settings to evaluate the self-care of home-dwelling elderly and factors associated with it. Methods: The instrument development was done in four phases. At the first phase, the initial version was created on the basis of the theory. At the second phase, two home-dwelling elders were pilot-interviewed, and 20 elders completed the structured questionnaire and commented upon its ease of use. The results were used to develop the second version of the instrument. At the third phase, the second version of the instrument was used to collect data from home-dwelling elders aged 75 or more from different parts of Finland (n = 200). Face validity, exploratory factor analyses, correlation coefficients and Cronbach's alpha were used to test and further develop the instrument. At the fourth phase, the content validity of the third version was assessed by three home-dwelling elders. Results: The agreement between the elders and the researchers about the contents of the instrument was acceptable, and exploratory factor analyses verified quite well the structure of the theory. Based on the Cronbach's alpha values (0.49-0.90), the internal consistency of the instrument was fairly good. Conclusion: The results provide sufficient evidence of the validity and reliability of the final version of the instrument, which has nine background questions and 82 items to measure the self-care of home-dwelling elderly and factors associated with it. Published by arrangement with John Wiley & Sons.

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